QUESTION SLIDE :
Supporting data: A woman of Mediterranean origins aged 30 years‚ the previously healthy mother of three children‚ now complaining of headaches and tiredness. Spleen palpable approximately 4 cm. below the left costal margin. Hb = 9.5 g/dl‚ red cell count 5.0 x10ˆ12/l. Examine the photomicrograph of the patient`s blood film‚ noting your findings and conclusions.
Answer : The red cells are microcytic and hypochromic. A target cell is shown (top left) and there are poikilocytes and small fragmentary forms. The MCH (which you could have obtained from the data provided) is 19 pg. The patient suffered from HbH disease‚ confirmed by electrophoresis and the HbH inclusions test. There was a neutrophil right shift‚ represented in the picture by the cell with six nuclear lobes‚ but a suspicion of folate deficiency was not confirmed by further investigations.
Supporting data: A woman of Mediterranean origins aged 30 years‚ the previously healthy mother of three children‚ now complaining of headaches and tiredness. Spleen palpable approximately 4 cm. below the left costal margin. Hb = 9.5 g/dl‚ red cell count 5.0 x10ˆ12/l. Examine the photomicrograph of the patient`s blood film‚ noting your findings and conclusions.
Answer : The red cells are microcytic and hypochromic. A target cell is shown (top left) and there are poikilocytes and small fragmentary forms. The MCH (which you could have obtained from the data provided) is 19 pg. The patient suffered from HbH disease‚ confirmed by electrophoresis and the HbH inclusions test. There was a neutrophil right shift‚ represented in the picture by the cell with six nuclear lobes‚ but a suspicion of folate deficiency was not confirmed by further investigations.
